>> so we have a perfect study in which 50 states you could track health costs, and some states like texas have set very severe caps. and they have not seen lower trend lines because they set the caps. so it's absolutely true that doctors practice defensive medicine, it's true that we need changes. that's all true. it won't fix the cost trends. the cost trends are because of unnecessary capacity, it's because of irrationality in the system, it's because of, you know, delivering too much of the wrong kinds of services. so, you know, you have lots of -- you know, the ama's answer to this and physicians' answer to this is always tort reform. and you can say, you know, yes, you're right, the tort system need to be fixed, but that's not the answer to the cost trends. >> well, thank you, dr. brenner. that was incredibly interesting. [applause] >> thank you so much. ms. . [applause] >> that, i want to ask dan, our nga executive director, to give us an update of the work on the association in assisting states to control health costs while maintaining quality. >> thank you. you probably won't be su